Exercise induced asthma (EIA) is characterized by breathing difficulties and wheezing subsequent to exercise. Vocal cord dysfunction (VCD) and exercise-induced laryngomalacia (EIL) are characterised by shortness of breath, stridor, chest pain and occasionally panic reactions during exercise. VCD and EIL may clinically mimic EIA and misdiagnosis should be avoided so that unnecessary asthma medication is not prescribed. However, there have been problems with investigating the situation after a patient has become distressed during exercise, even transnasal laryngoscopy being difficult in such circumstances.